Non-FDA-Approved Uses of Apremilast in Dermatology: A Review of Current Available literature

Introduction: Apremilast, an oral phosphodiesterase-4 inhibitor, decreases the production of pro-inflammatory cytokines including tumour necrosis factor-α, interleukin-12/23, IL-12, IL-2, and interferon-γ; while upregulating anti-inflammatory cytokine IL-10. Its pan-immunomodulatory nature has led to its use in managing various immune-mediated dermatoses for non-FDA-approved indications. Objectives: To review analyze Apremilast Non-FDA-approved indications current available literature. Materials methods: PubMed, EMBASE, SCOPUS, Google scholar databases were searched with parameters “Apremilast”, “Apremilast NOT Psoriasis*”, Behçet’s*”, arthritis*”. A total 45 relevant articles chosen review. Results: We found 22 dermatology where apremilast been used without FDA approval. The best evidence was treatment Atopic Dermatitis, Alopecia Areata, Hidradenitis Suppurativa, randomized controlled trials. Prospective open-label trials Cutaneous Sarcoidosis, Lichen Planus, Rosacea, Vitiligo. Individual case series reports Acrodermatitis Continua Hallopeau, Dermatomyositis, Disseminated Granuloma Annulare, Erythema Nodosum Leprosum, Morphea, Pityriasis Rubra Pilaris, Hailey-Hailey Disease, Recurrent Multiforme, Folliculitis Decalvans, Prurigo Nodularis, Perforating Dermatoses, Chronic Actinic Hand Eczema, Epidermolysis Bullosa Simplex-Generalised Severe Type. shown varied efficacy despite a better safety profile tolerability over long duration compared conventional immunosuppressant drugs placebo. Conclusion: variable efficacy. Better controlled, studies adequate sample size drug comparisons are needed analyses.